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631- 589 -8100
33. -2 -17
BOX 13
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01398
PUPNAM COUNTY HEALTH DEPARTMENT
DIVISION OF ENVIRONMENM HEALTH SERVICES
225 -0310.
-p F0S;kb= FGR--S39-aM- =LISP -:SY67 ,-REPAIi
atm, S NAME SGT/ 2 %�2GLk P'� 2� it d PHONE
SITE IMTION r� S. TKO
MAILING ADDRESS CAST -•,. e- C
PERSON INTERVIEWED PCHD Camplaint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE 1 " /0 S �J - -- TYPE FACILITY
PHONE Sze- /0070
Proposal (include sketch locating all adjacent wells):
NOTE: Repair must be in same location and of same type as original,sewage disposal system.
Different location may require submittal of proposal from licensed professional engineer or
registered architect.
Proposal approved Proposal Disapproved
Inspector's Signature a to
Proposal.approved with the following conditions:
1. Procurement of any Town permit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name.
b. Site Street Name, Town and Tax Map number.
c. Location of installed components tied to two fixed points (e.g.,house corners).
d. System description (e.g., 1250 gal, concrete septic tank, three precast 6' diam, x 6' deep
drywells surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or ag f owner agree to the above conditions. f
SIGNATME TITLE DATE
PISS: Vitiate (PAD); YeUr w 03pn EU; Pink (A pli®nt)
3ITE
TO
AILING ADDRESS GL (,, &L
PERSON INTERVIEWED PCHD Canplaint #
Name & Relationship (i.e, owner,tenant, etc.)
DATE — q - g g TYPE FACILITY
PROPOSED INSTALLER � c�.� -� s /�'LK. -e, � L� PHCNE F2- if - / 00 0
Pr sal (include sketch locating all adjacent wells);
NOTE: Repair must be in same location and of same type as original sewage disposal system.
Different location may require submittal of proposal from licensed professional engineer or
registered architect.
X121/ 1 �tOftJ-e- ( ,,� �3
Go ' ,
Proposal approved ,_ Proposal Disapproved
proposal approved with the following conditions:
1. Procurement of any Townpermit, if applicable.
2. Submission of as built repair sketch in duplicate showing:
a. Owner's name.
b. Site Street Namef Town and Tax Map number. -
c. Location of installed components tied to two fixed points (e.g.,house corners).
d. System description (e,g., 1250 gal. concrete septic tank, three precast 6' diam. x 6' deep
.drywells surrounded by one foot + gravel).
e. Installer's name and number.
3. System repair to be performed in accordance with the above proposal and conditions.
I, as owner, or r rted t of owner agree to the above conditions.
SIGNATURE TITLE CO 1 -4 �® r
. TES: WAte MD); Ye].lcw Mac ffi); Pink ( Yt)
P. F. BEAL & SONS, INC.
ARTESIAN WELLS 4 PUTNAM AVENUE JET PUMPS
GRAVEL SCREENED WELLS - BREWSTER. NEW YORK 10509 SUBMERSIBLE PUMPS
WATER SYSTEMS p p / .n AA SUCTION PUMPS
.' WATER SOFTNERS ,�btngGia!i8,9� _(�aGt 6A,Q.Q.eus G:O,.n�r.,��scd_r__...,. _ CELLAR DRAINERS-
... .. ....... :...._ _._... a- .V.:.__...._.... ..
"°WATER •CONDITIONINGaECU1PMENT� -- -----.-z =�_„ _ ., _ ... -. �. - T1R0TORS- TANKS - BELTS =ETC:" "
TEL. BR 9 -2460 - 2461
COMPLETE INSTALLATION, REPLACEMENT AND REPAIR SERVICE
January 10, 1989
Putnam Cty. Health Dept.
Old Rte. 6
Carmel, NY 10512
Dear Mr. Keck,
Please be advised that on January 9, 1989 we traced the
water line at the residence' of Mrs. Swee Maurizio on Terry Hill
Road, Carmel, NY.. The well is approximately -.ten feet in front
of the house. If you have any questions feel free to call me at
my office.
Very truly yours,
'COUNT)Y,(OF WESTOH98T99
E -T1 Red 86. DEPARTMENT OF LABORATORIES ICNO, RESEARCF� a
NALHALLA.NEW YORK tQ5$S.
° BACTEMAL EXAMIN.AT'ION OF bR)NKING ANb TREATED WATERS
f � „
Lab Wo W.-
Bottle Na
R
L•ab No it yDate Co)I.'tl
Time Set - Time $u6mitted' - --
Tgsts (C�,rcfe) SPCli }ormIMPNF(Golform Me;►nb4an ;FecaOtjtGr _ _'
Coll d,b�CEi Agericy•Coll d:fgi
3
Coll d from; Name , 4`_ { a_ f a
(F"t)
AdSlregs t -t is - (Pay Town V, Imo.i 11
14enttliaeon of SociiceR
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Sainplirtg'omt wlthrrl P►emiaea _�- -� :Refngerated?
tfticgriri$tod ?' Yes o Nb n
,z
fiEuliLTS Of EXAMINATION OF WATER _
€ -
fr}PN /100 rtml`
` , { Siar)dard�Plale Count � �?
p xA Bactera per
ml
,Membrahi,"Meth6d /1.00 ml ' h
Number Positive TUb" 1 Totai Cgliform
FeQal •�ol(form <— �"� �-��1 � � Other � � � - � ��
r--.
n These results. indicate sampIs,, `waa was not) o} Reported by ;_ _ Dete 3
sat 6 /ac'tory ssnttary fquali y wh' a sample Was
collected
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OWNERI S NAME i V e 2: A-11tri 210 PHCNE
SITE LOCATION - {�,�(� ��f', TK#
MAILING ADDRESS C I 1
PERSON INTERVIEWED PC HD C Tiplaint .
Name & Relationship (i.e, owner,tenant,'etc.)
DATE — _ g T^ TYPE FACILITY
PROPOSED INSTALLER r 1< 6- s M,-t, L Lk-� PHONE' S 2- e- / o o o
Proposal (include sketch locating all adjacent wells);
NOTE: Repair must be in same location ,and of -same, type as original sewage disposal_ system.
Different location may require submittal of` proposal fran licensed professional engineer or
registered architect.
F
h/ @.I1 I . ' — 1-� • .) .
X. r.. i� ��9�� --•ice. � S
Proposal approved , _ Proposal Disapproved
Proposal approved with the following conditions:
1. Procurement of any Town peanit, if applicable.
2. Submission of as ?wilt repair sketch in duplicate showing:
a. Cleaner's name.
b. Site - Street Namer 'Down and Tax Map number.
c. Location of installed components tied to two fixed points
d. System description (erg., 1250 gal. concrete septic tank,
drywe]lls surrounded by one foot + gravel).
e. Installer s name and number.,
(e.g. house corners).
three precast 6' diam. x 6' deep
3. System repair to be psrfonmed.in accordance with the above proposal and conditions.
I, as owner, or r rted ant of owner agree to the above conditions. q
SIGNATURE TITLE CO DATE" " 8/
IPtEI : Vbite (PQD); YeUc w (M:kt1 ffi); Pink 042 hunt)
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